Q&A Topic: Bone Grafting

November 7, 2016

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Michael Graffeo, DDS

Q: What is bone grafting?A: Bone grafting refers to a procedure to replace bone where it is missing or is inadequate using a variety of materials. Bone grafting can be used to reconstruct defects of the jaw or to reconstruct regions of the jaw bone in preparation for dental implant placement. They include your own bone taken from your chin, back of your jaw, tibia, or hip, bone from a cadaver, from an animal, or created from synthetic materials.

Q: When is bone grafting recommended?A: When teeth are extracted, a bone graft that is routinely placed is demineralized freeze-dried bone (DFDB), which is placed in the extraction socket to maintain the integrity of the extraction site. A membrane is routinely placed over the grafting site to hold in the bone grafting material, as well as to prevent the soft tissue from growing into the bone graft.Bone grafting is also placed along the jaw bones to reconstruct defects from previous extraction sites that were not grafted or in patients who have been missing teeth for years. Bone grafting can also be used for sinus augmentation, which involves raising the sinus floor and reconstructing the sinuses to add more grating material for the placement of future dental implants.

Q: What conditions require bone grafting?A. We primarily do bone grafting for patients who have been missing teeth for years and are wearing dentures or have bridgework to replace one or more missing teeth. The procedure is also used for patients who have congenitally missing teeth, tumors, or serious injuries from accidents.

Q: What can be expected during a consultation?A: At our office, patients undergo a thorough evaluation that includes a clinical examination and radiographic studies. We have state-of-the-art technology, which includes a Cone Beam CT Scanner that allows us to view your jaw bone in three dimensions. We will then determine how much adequate bone you have from both a horizontal and vertical aspect. We will discuss your options and walk you through each step, starting with grafting to the final restoration that restores your smile with teeth. Our software allows us to perform virtual surgery and place implants in your jaw bone. We will also discuss your options for anesthesia, including the option to have general anesthesia with the help of your board certified oral and maxillofacial surgeon.

Q: What are the benefits of bone grafting?
A: When one or more teeth are missing, it can lead to jaw bone loss at the site of the missing tooth/teeth. This loss of jaw bone can develop into additional problems, related to both your appearance and your overall health. You may experience pain, problems with your remaining teeth such as misalignment, drifting, or loosening; an altered facial appearance; a collapsed facial profile; skin wrinkling around the mouth; jaw pain; and eventually even lose the ability to speak and eat normally. Good jaw bone health is essential to your overall health. To prevent serious dental health issues, it’s important to seek treatment at the first signs of poor jaw bone health.

Dr. Graffeo is a Board-certified oral and maxillofacial surgeon and a member, fellow, and Diplomate of the American Board of Oral and Maxillofacial Surgeons. He has lectured on various topics, including full-scope oral and maxillofacial surgery with a concentration in reconstruction, dental implantology, bone grafting, and noninvasive cosmetic surgery.